Individual
DAISHA B WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-0100
Mailing address
6201 GREENLEIGH AVE, BALTIMORE, MD 21220-2004
(410) 933-6423
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
901643
MS
367500000X
Certified Registered Nurse Anesthetist
Primary
AC006496
MD
Other
Enumeration date
04/09/2012
Last updated
07/28/2025
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